Obstetrical fracture-separation of the upper femoral epiphysis.

During the last 15 years we have treated six neonates with obstetrical fracture of the upper epiphysis of the femur. Two other cases have previously been reported by one of us (S.D.T.) in 1958. A common characteristic was a difficult and traumatic breech delivery, half the babies being "large-for-dates". The clinical and radiological signs of this injury are described. In two babies there were associated injuries of the same limb whilst two others had congenital dislocation of the contralateral hip. The prognosis appears to be excellent, in spite of the severity of the injury, and irrespective of treatment.